MedWorm: Atrial Septal Defect

Pacemaker endocarditis: approach for lead extraction in endocarditis with large vegetations

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

We report two patients with large vegetation on the ventricular lead due to endocarditis and one of them with an atrial septal defect associated. It was applied a combined technique of transvenous lead removal and sternotomy with cardiopulmonary bypass for the complete removal of pacemaker wires. This procedure resolved the pacemakers endocarditis safely and subsequently a new transvenous device was placed on the opposite site.A presença de grande crescimento vegetativo no eletrodo do marca-passo impõe dificuldades adicionais para a sua extração, pois alguns métodos não podem ser aplicados pelo risco potencial de embolismo. Reportamos dois pacientes com grande crescimento vegetativo no eletrodo ventricular, devido a endocardites, um deles com comunicação intraventricular associada....

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Minimally invasive video-assisted atrial septal defect correction and myocardial revascularization

Revista Brasileira de Cirurgia Cardiovascular — Fri, 19 Mar 2010 17:46:08 +0100

We describe the use of this technique during an off-pump correction of a coronary artery fistula associated with right coronary dilatation. The suggested technique is quicker and less complex than on-pump surgery. Furthermore, it can be a useful tool for congenital fistula correction in select cases, stimulating the practice of less invasive heart surgery in these patients. (Source: Revista Brasileira de Cirurgia Cardiovascular)

Lower Ministernotomy and Fast Tracking for Atrial Septal Defect [ORIGINAL ARTICLE]

Asian Cardiovascular and Thoracic Annals — Fri, 19 Mar 2010 09:53:54 +0100

We report our experience with a 3–5-cm lower ministernotomy incision for closure of atrial septal defect in 53 patients. Fibrillatory arrest was used in 19 patients, and crossclamping with cardioplegia in 33. One patient had to be converted from fibrillatory arrest to crossclamping with cardioplegic arrest. The mean bypass time was 39.6 ± 13.1 min, arrest time was 9.9 ± 4.5 min, and crossclamp time was 20.7 ± 8.69 min. All patients recovered without adverse events. They were fast tracked to recovery and extubated after 63.4 ± 9.2 min. The mean intensive care unit stay was 1.07 ± 0.33 days, and hospital stay was 3.07 ± 0.38 days. The ministernotomy approach was used successfully in 51 patients; in the other 2, it had to be converted to a full ...

The Impact of Transcatheter Atrial Septal Defect Closure in the Older Population: A Prospective Study

Journal of the American College of Cardiology: Cardiovascular Interventions — Mon, 15 Mar 2010 20:59:21 +0100

Conclusions Our data demonstrated that ASD closure at advanced age results in favorable cardiac remodeling and improvement of functional class. (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)

The Arterial Switch Operation: The “Open” Technique for Coronary Transfer

Operative Techniques in Thoracic and Cardiovascular Surgery: A Comparative Atlas — Mon, 15 Mar 2010 16:57:36 +0100

At Children's Medical Center Dallas, the arterial switch operation is routinely performed with bicaval cannulation, continuous cardiopulmonary bypass (CPB), and moderate hypothermia of 25 to 28°C. Methylprednisolone (10 mg/kg IV) is administered 8 to 12 hours preoperatively. A pH stat strategy is typically employed with a hematocrit target of 35%. Phentolamine (0.2 g/kg) is administered for [alpha]-adrenergic blockade after initiating CPB. Flow rates vary between 150 and 200 mL/kg/min at normothermia, and 75 and 125 mL/kg/min at hypothermia. Cerebral and flank near-infrared spectroscopy indices are monitored routinely and used (in addition to continuous blood gas analysis) to assess the adequacy of perfusion. Associated intracardiac defects except for the atrial septal defect, which facil...

[Percutaneous closure of two atrial septal defects with individual septal occluder devices.]

Turk Kardiyoloji Dernegi arsivi — Fri, 12 Mar 2010 11:50:04 +0100

Authors: Ilkay E, Fırat S, Dağlı N, Ozeke O A 20-year-old male patient presented with dyspnea and palpitation. An atrial shunt was detected on transthoracic echocardiography. Transesophageal echocardiography (TEE) showed two secundum atrial septal defects (ASD), 13 mm and 15 mm in size, respectively. There was no other congenital heart disease. During right heart catheterization, pulmonary artery pressure was 40 mmHg and the Qp/Qs ratio was 1.9. His coronary arteries were normal. The patient underwent elective percutaneous ASD closure under general anesthesia and continuous TEE monitoring. The distance between the two defects was 16 mm. Two 25-mm PTS sizing balloon catheters were simultaneously inflated, yielding maximum defect diameters of 13 mm and 15 mm. First the ...

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[Evaluation of adult congenital heart diseases.]

Turk Kardiyoloji Dernegi arsivi — Fri, 12 Mar 2010 11:50:04 +0100

CONCLUSION: In our study, atrial and ventricular septal defects accounted for the majority of CHDs in adult patients (69.5%). Multicenter studies are required to determine the incidence of CHD among adult population in Turkey. PMID: 20215839 [PubMed - as supplied by publisher] (Source: Turk Kardiyoloji Dernegi arsivi)

Congenital Left Main Coronary Artery to Main Pulmonary Artery Fistula with Bicuspid Aortic Valve: A Case Report and Review of Literature

Journal of Cardiac Surgery — Mon, 08 Mar 2010 00:00:00 +0100

We report on a 68-year-old man with congenital left main to pulmonary artery fistula associated with bicuspid aortic valve and moderate aortic stenoses, who underwent successful aortic valve replacement with ligation of CAF and also review the natural history, pathophysiology, and management of CAF. (J Card Surg ****;**:**-**) (Source: Journal of Cardiac Surgery)

Heterogeneity of Genetic Modifiers Ensures Normal Cardiac Development.

Circulation — Mon, 08 Mar 2010 00:00:00 +0100

Conclusions-Alleles of modifier genes can either buffer perturbations on cardiac development or direct the manifestation of a defect. In a genetically heterogeneous population, the predominant effect of modifier genes is health. PMID: 20212279 [PubMed - as supplied by publisher] (Source: Circulation)

Radiofrequency Catheter Ablation of Parasystole Originating from the Inferior Vena Cava

Pacing and Clinical Electrophysiology : PACE — Fri, 05 Mar 2010 00:00:00 +0100

A 76-year-old man with a history of atrial septal defect repair underwent radiofrequency (RF) ablation of typical atrial flutter. During electrophysiological study, incessant sharp potentials were recorded, originating from the ostium of the inferior vena cava (IVC), and dissociated from atrial activity. During sinus rhythm, these potentials propagated to the atria and caused premature complexes when falling beyond the atrial refractory period. Electro-anatomical mapping revealed the presence of the earliest potential in the postero-lateral ostium of the IVC, propagating to the septal region. After RF isolation of the IVC, the patient has remained arrhythmia-free over a 5-year follow-up. (PACE 2010; e1[ndash]e4) (Source: Pacing and Clinical Electrophysiology : PACE)

Paxil Birth Defect Trial: Battle of the Experts

NaturalNews.com — Tue, 02 Mar 2010 07:00:00 +0100

(NaturalNews) In the first Paxil birth defect trial that resulted in a $2.5 million verdict against GlaxoSmithKline in October 2009, the infant, Lyam Kilker, was born with three heart defects; an atrial septal defect, a ventricular septal defect, and an interrupted aortic arch, after his mother took Paxil while pregnant. Pregnant women cannot participate in clinical trials on drugs due to the risk of harm to the fetus. But after a drug has been on the market for a while, epidemiology studies can review the medical records of women who have taken a new drug while pregnant and the records of women who were not exposed to the drug while pregnant and compare the outcomes of the infants.The plaintiff's experts, Doctors Ra-id Abdulla, David Healy, Shira Kramer and Suzanne Parisian, all testified...

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The Nuss Procedure for Pectus Excavatum at the Time of Atrial Septal Closure [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 22:46:26 +0100

A 25-year-old man with severe pectus excavatum and an atrial septal defect had simultaneous repair of the defects, using a patch for closure of the defect and placement of a Nuss bar for the chest wall defect. Details of the procedure and outcome are described. (Source: The Annals of Thoracic Surgery)

The Nuss Procedure for Pectus Excavatum at the Time of Atrial Septal Closure.

The Annals of Thoracic Surgery — Tue, 23 Feb 2010 13:08:47 +0100

Authors: Kao CH, Tsai CS, Huang TW, Lee SC, Cheng YL A 25-year-old man with severe pectus excavatum and an atrial septal defect had simultaneous repair of the defects, using a patch for closure of the defect and placement of a Nuss bar for the chest wall defect. Details of the procedure and outcome are described. PMID: 20172179 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

Left Ventricular Myxoma Accompanied with Congenital Atrial Septal Defect

Journal of Cardiac Surgery — Tue, 23 Feb 2010 00:00:00 +0100

(J Card Surg ****;**:**-**) (Source: Journal of Cardiac Surgery)

Persistent iatrogenic atrial septal defect after a single-puncture, double-transseptal approach for pulmonary vein isolation using a remote robotic navigation system: results from a prospective study

Europace — Sat, 20 Feb 2010 14:44:32 +0100

Conclusion After a single-puncture, double-transseptal approach for PVI using the RNS, iASDs show a high spontaneous closure rate of 78.9% after a 6-month FU period. Persistent iASDs following PVI with the RNS are not associated with an increased rate of paradoxical embolism or with relevant shunting. (Source: Europace)

Multimodality imaging of a pacemaker lead crossing a primum atrial septal defect

Europace — Sat, 20 Feb 2010 14:44:32 +0100

(Source: Europace)

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Iatrogenic atrial septal defect after catheter ablation of atrial fibrillation: do we have to worry?

Europace — Sat, 20 Feb 2010 14:44:31 +0100

(Source: Europace)

Segmental Pigmentation Disorder.

The British Journal of Dermatology — Mon, 15 Feb 2010 00:00:00 +0100

Conclusions: Segmental Pigmentation Disorder is a relatively common pigmentary anomaly and most affected individuals are otherwise healthy. We propose reviving the term coined by Metzker et al, "Segmental pigmentation disorder" to describe children with segmental and block-like hypo/ hyper pigmentation with midline demarcation. PMID: 20163411 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)

Percutaneous successful closure of dual atrial septal defect with two Amplatzer septal occluder devices

Clinical Research in Cardiology — Wed, 03 Feb 2010 17:55:26 +0100

We report a case of percutaneous dual atrial septal defect closure with two Amplatzer septal occluder devices. Content Type Journal ArticleCategory Clinical CorrespondenceDOI 10.1007/s00392-010-0124-zAuthors Hamza Duygu, Ataturk Training and Research Hospital Izmir TurkeyHalit Acet, Ataturk Training and Research Hospital Izmir TurkeyUgur Kocabas, Ataturk Training and Research Hospital Izmir TurkeyZehra Ilke Akyildiz, Ataturk Training and Research Hospital Izmir TurkeyCem Nazli, Ataturk Training and Research Hospital Izmir TurkeyOktay Ergene, Ataturk Training and Research Hospital Izmir Turkey Journal Clinical Research in CardiologyOnline ISSN 1861-0692Print ISSN 1861-0684 (Source: Clinical Research in Cardiology)

Brain Abscess in an Adult With Atrial Septal Defect

Clinical Cardiology — Tue, 02 Feb 2010 00:00:00 +0100

This article describes the case of a 41-year-old man who presented with altered mental status. Brain MRI showed a brain abscess at the left frontal lobe. The patient was successfully treated with surgical removal and appropriate antibiotics. Echocardiographic examination showed atrial septal defect (ASD) with bidirectional shunt. Transcatheter closure of ASD was carried out 6 months after neurosurgical treatment. We discuss the association of brain abscess and ASD. Copyright © 2009 Wiley Periodicals, Inc. (Source: Clinical Cardiology)

Noninvasive Creation of an Atrial Septal Defect by Histotripsy in a Canine Model.

Circulation — Mon, 01 Feb 2010 00:00:00 +0100

Conclusions-Under real-time ultrasound guidance, atrial septal defects were successfully created with extracardiac histotripsy in a live canine model. Although further studies in an intact animal model are needed, these results provide promise of histotripsy becoming a valuable clinical tool. PMID: 20124126 [PubMed - as supplied by publisher] (Source: Circulation)

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Residual atrial septal defect after percutaneous closure with an Amplatzer device [Images in cardio-thoracic surgery]

European Journal of Cardio-Thoracic Surgery — Thu, 28 Jan 2010 19:40:37 +0100

(Source: European Journal of Cardio-Thoracic Surgery)

Totally endoscopic closure of an atrial septal defect using the da vinci surgical system: Report of four cases

Surgery Today — Wed, 27 Jan 2010 20:05:42 +0100

This report presents four cases of totally endoscopic closure of an atrial septal defect using the da Vinci Surgical System (Intuitive Surgical, Mountain View, CA, USA). The patients were diagnosed with an ostium secundum atrial septal defect and elected to undergo minimally invasive surgery. A cardiopulmonary bypass was established via cannulation of the femoral vessel and jugular vein, and blood cardioplegic arrest was induced using a transthoracic cross-clamp. The mean extracorporeal circulation and cardiac arrest times were 86 ± 21 and 22 ± 8 min, respectively. No patient experienced pain after surgery, and all were fast-tracked for early discharge and released on postoperative day 3. No intraoperative or postoperative complications occurred. This procedure permitted a short ho...

The Relative Atrial Index (RAI)—A Novel, Simple, Reliable, and Robust Transthoracic Echocardiographic Indicator of Atrial Defects

Journal of the American Society of Echocardiography — Mon, 25 Jan 2010 00:00:00 +0100

Conclusion: The RAI, a novel and simple transthoracic parameter, reliably identifies patients with possible atrial shunting. The resolution of right atrial enlargement occurs remarkably early after percutaneous ASD closure, as demonstrated by this novel parameter. (Source: Journal of the American Society of Echocardiography)

Right to left shunt following radiofrequency catheter ablation of atrial fibrillation in a patient with complex congenital heart disease

Europace — Wed, 20 Jan 2010 16:18:37 +0100

We report a case of an iatrogenic atrial septal defect following left atrial ablation for persistent atrial fibrillation in a patient with a Fontan circulation. Transseptal puncture was performed with two sheaths across a single puncture and left atrial ablation undertaken. Post procedure the patient became cyanosed with right to left shunting. Transcatheter closure immediately improved symptoms and oxygen saturation. (Source: Europace)

Morphologic, Mechanical, Conductive, and Hemodynamic Changes Following Transcatheter Closure of Atrial Septal Defect

Congenital Heart Disease — Wed, 20 Jan 2010 00:00:00 +0100

Conclusions. Transcatheter ASD closure is followed by morphologic, conductive, and hemodynamic changes at different time intervals during the first years and results in normalization or near normalization of the heart's structure and function. (Source: Congenital Heart Disease)

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Long-Term Follow Up of Secundum Atrial Septal Defect Closure with the Amplatzer Septal Occluder

Congenital Heart Disease — Wed, 20 Jan 2010 00:00:00 +0100

Conclusion. These data indicate that for up to 120 months of patient follow-up, the ASO continues to be a safe device. Residual shunts and arrhythmias have low incidence post-ASO placement. Given the mortality in one high-risk patient, further investigation into anti-platelet therapy after device placement is warranted. (Source: Congenital Heart Disease)

Adults with Down Syndrome: Safety and Long-term Outcome of Cardiac Operation

Congenital Heart Disease — Wed, 20 Jan 2010 00:00:00 +0100

Conclusion. At an experienced center, adult patients with Down syndrome can undergo cardiac surgery with a low risk of mortality and acceptable morbidity. Atrial arrhythmias and pulmonary infections are common postoperatively. (Source: Congenital Heart Disease)

Unicuspid Aortic Valve, Hand AnomaliesA Heart-Hand Syndrome.

The American Journal of the Medical Sciences — Tue, 19 Jan 2010 00:00:00 +0100

Authors: Nanda S, Longo S, Arastu MI Embryonic heart and limb development are closely related with >100 known inherited disorders affecting both. Common limb defects include duplication, deficiencies, and hypoplasia. Ventricular septal defects and atrial septal defects are the commonest associated cardiac conditions. A positive association exists between heart defects and limb disorders when these disorders are analyzed separately. Closer associations exist between heart defects and upper limb defects compared with lower limb defects. The majority of limb defects occur in the more distal parts of the affected limb. Genes expressed in both the heart and limb development include TGF-beta, BMP4, Msx transcription factor, HAND gene, retinoic acid receptor, and sonic hedgehog gene. Radia...

Intermediate-Term Effects of Transcatheter Secundum Atrial Septal Defect Closure on Cardiac Remodeling in Children and Adults

Pediatric Cardiology — Mon, 18 Jan 2010 18:44:04 +0100

Abstract The study aimed to investigate the intermediate-term effects of transcatheter atrial septal defect (ASD) closure on cardiac remodeling in children and adult patients. Between December 2003 and February 2009, 117 patients (48 males, 50 adults) underwent transcatheter ASD closure with the Amplatzer septal occluder (ASO). The mean age of the patients was 15 years, and the mean follow-up period was 25.9 ± 12.4 months. New York Heart Association (NYHA) class, electrocardiographic parameters, and transthoracic echocardiographic (TTE) examination were evaluated before the ASD closure, then 1 day, 1 month, 6 months, 12 months, and yearly afterward. Transcatheter ASD closure was successfully performed for 112 (96%) of the 117 patient...

Pearls for Ablation in Congenital Heart Disease

Journal of Cardiovascular Electrophysiology — Fri, 15 Jan 2010 00:00:00 +0100

This article focuses on the technical aspects of catheter ablation of these arrhythmias, due to the challenges presented by the underlying anatomy compared with patients having normal hearts. (J Cardiovasc Electrophysiol, Vol. pp. 1-8) (Source: Journal of Cardiovascular Electrophysiology)

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Late device thrombosis after atrial septal defect closure

European Heart Journal — Thu, 14 Jan 2010 08:06:40 +0100

(Source: European Heart Journal)

Popliteal pterygium associated with atrial septal defect

European Journal of Orthopaedic Surgery & Traumatology — Mon, 11 Jan 2010 18:20:50 +0100

Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00590-009-0572-1Authors Hironobu Koseki, Nagasaki University Department of Orthopedic Surgery, Graduate School of Biomedical Science 1-7-1, Sakamoto Nagasaki 852-8501 JapanToshiyuki Tsurumoto, Nagasaki University Department of Orthopedic Surgery, Graduate School of Biomedical Science 1-7-1, Sakamoto Nagasaki 852-8501 JapanHiroyuki Shindo, Nagasaki University Department of Orthopedic Surgery, Graduate School of Biomedical Science 1-7-1, Sakamoto Nagasaki 852-8501 Japan Journal European Journal of Orthopaedic Surgery & TraumatologyOnline ISSN 1432-1068Print ISSN 1633-8065 (Source: European Journal of Orthopaedic Surgery & Traumatology)

Congenital Left Ventricle-to-Pulmonary Artery Fistula

Journal of the American College of Cardiology — Fri, 08 Jan 2010 13:50:11 +0100

An 11-month-old girl presented with tachypnea and a grade 3/6 systolic heart murmur on her physical examination when receiving a scheduled vaccination. Chest radiography showed cardiomegaly and increased lung markings. Transthoracic color Doppler echocardiography showed a type-2 atrial septal defect and an abnormal turbulent flow from the lateral wall of the left ventricle (LV), but both coronary arteries appeared normal. Cardiac catheterization was performed that revealed 2 oxygen-saturation step-ups, 1 at the right ventricle (from 62% to 85%) and the other at the pulmonary artery (PA) (from 85% to 87%), with a total Qp/Qs of 3.5. An angiogram of the LV showed 2 fistulas originated from the lateral wall of the LV and then joined together to drain into the posterior-lateral side of the PA ...

Cardiac remodeling and effects on exercise capacity after interventional closure of atrial septal defects in different adult age groups

Clinical Research in Cardiology — Fri, 08 Jan 2010 09:08:53 +0100

Conclusion Patients benefit from interventional closure of hemodynamically significant ASD regardless of their age. However, the defect should be repaired as early as possible to prevent hemodynamic complications, such as the development of pulmonary hypertension and cardiac arrhythmias. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00392-009-0105-2Authors Smita Jategaonkar, Städt. Klinikum Braunschweig Department of Internal Medicine 2 Braunschweig GermanyWerner Scholtz, Ruhr University Bochum Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia Georgstr. 11 32545 Bad Oeynhausen GermanyHenning Schmidt, Ruhr University Bochum Department of Cardiology, Heart and Diabetes Center North Rhine-Westphalia Georgstr. 11 32545 Bad Oeynh...

Incidence of atrial fibrillation after percutaneous closure of patent foramen ovale and small atrial septal defects in patients presenting with cryptogenic stroke

International Journal of Stroke — Thu, 07 Jan 2010 00:00:00 +0100

The occurrence of atrial fibrillation after percutaneous closure of a patent foramen ovale for cryptogenic stroke has been reported in a variable percentage of patients. However, its precise incidence and mechanism are presently unclear and remain to be elucidated. Prospective follow-up study. Ninety-two patients undergoing a percutaneous patent foramen ovale closure procedure (closure group) for cryptogenic stroke were compared with a similar group of 51 patients, who were medically treated. A systematic arrhythmia follow-up protocol to assess the incidence of AF was performed including a 7-day event-loop recording at day 1, after 6 and 12 months in patients of the closure group and compared with those of the medically treated group. The incidence of AF was similar in both study groups du...

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Late Bacterial Endocarditis of an Amplatzer Atrial Septal Defect Occluder Device

The American Journal of Cardiology — Tue, 05 Jan 2010 13:52:39 +0100

In conclusion, the present report is the first description of late infective endocarditis in an adult with an ASO. (Source: The American Journal of Cardiology)

Early timing of surgical intervention in patients with Ebstein's anomaly predicts superior long-term outcome [Original articles]

European Journal of Cardio-Thoracic Surgery — Mon, 04 Jan 2010 16:40:24 +0100

Conclusions: Repair, as opposed to replacement, is feasible in the vast majority of patients presenting with Ebstein's anomaly with a low early mortality rate. Outcome, in terms of survival and freedom from re-operation in the long term is determined by the clinical state at the time of surgery. Therefore, timely operation is warranted before significant cardiomegaly develops and functional status deteriorates. (Source: European Journal of Cardio-Thoracic Surgery)

Fast-track paediatric cardiac surgery: the feasibility and benefits of a protocol for uncomplicated cases [Original articles]

European Journal of Cardio-Thoracic Surgery — Mon, 04 Jan 2010 16:40:24 +0100

Conclusion: A fast-track programme can be implemented safely and effectively if the appropriate support including a step-down ward area is put in place. Greater experience with this type of protocol leads to reductions in the length of hospital stay for children aged over 6 months undergoing uncomplicated open-heart surgery. Fast-track cases should be performed in the morning. (Source: European Journal of Cardio-Thoracic Surgery)

Closure of a coexisting ostium secundum atrial septal defect and patent foramen ovale using a single Amplatzer patent foramen ovale occluder device

Cardiovascular Revascularization Medicine — Fri, 01 Jan 2010 00:00:00 +0100

We report the case of a 59-year-old man with cryptogenic stroke who was found to have both an ostium secundum atrial septal defect and a patent foramen ovale (PFO) by intracardiac echocardiography. Both defects were successfully occluded using a single 35-mm Amplatzer PFO occluder device inserted through the atrial septal defect. (Source: Cardiovascular Revascularization Medicine)

Aorto-Left Atrial Fistula Post-Percutaneous Device ASD Closure

Heart, Lung & Circulation — Fri, 01 Jan 2010 00:00:00 +0100

We describe a case of perforation with intracardiac fistula formation, with an underlying mechanism likely to be similar to the few cases previously described, occurring during medium term follow up after ASD device closure. Appropriate case selection can reduce the incidence of this complication with caution taken in ASD cases with deficient aortic and superior rims. (Source: Heart, Lung & Circulation)

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Role of intraoperative echocardiography in surgical correction of the superior sinus venosus atrial septal defect.

Annals of Cardiac Anaesthesia — Fri, 01 Jan 2010 00:00:00 +0100

Authors: Gadhinglajkar S, Sreedhar R, Jayakumar K, Misra M, Ganesh S, Mathew T Superior type of sinus venosus atrial septal defect (SVASD) is invariably associated with the unroofing of right upper pulmonary vein (RUPV). Warden procedure and pericardial patch repair with rerouting of the RUPV are commonly performed operations for the superior SVASD. Both operations involve the risk of obstruction to the flow of superior vena cava or rerouted pulmonary vein in the postoperative period. The sinus venosus defects are well visualized on the transesophageal echocardiography (TEE) because of the proximity of the TEE probe to these structures. We are reporting two cases operated for the superior SVASD with unroofed RUPV, highlighting the intraoperative echocardiographic features before and af...

Abdominal aortic embolization of a figulla atrial septum occluder device, at the level of the celiac axis, after an atrial septal defect closure: hybrid attempt.

Vascular — Fri, 01 Jan 2010 00:00:00 +0100

Authors: Jahrome AKh, Stella PR, Leijdekkers VJ, Guyomi SH, Moll FL A 41-year-old woman was treated with a Figulla (Occlutec, Helsingborg, Sweden) atrial septum occluder device with no intraprocedural complications. Five months later, dislocation of the device in the abdominal aorta was detected. The occluder device was located at the level of the celiac axis, nearly obstructing the entire aorta. Owing to total incorporation of the device, endoluminal retrieval was not possible. Through a medial rotation approach, the device was safely removed. This is a rare complication after endoluminal closure of an atrial septum defect. The retrieval possibilities are discussed. PMID: 20122364 [PubMed - in process] (Source: Vascular)

[Percutaneous treatment of Lutembacher syndrome: a case report.]

Turk Kardiyoloji Dernegi arsivi — Fri, 01 Jan 2010 00:00:00 +0100

We present a 49-year-old woman with Lutembacher syndrome. On pretreatment transthoracic echocardiography, planimetric mitral valve area was 1.5 cm(2), maximum diastolic gradient was 17 mmHg, and mean diastolic gradient was 9 mmHg. Combined percutaneous treatment was performed including balloon valvuloplasty for MS and closure of the ASD with the Amplatzer septal occluder. The patient was discharged uneventfully. Transthoracic echocardiography performed a week later showed planimetric mitral valve area as 2.1 cm(2), maximum diastolic gradient as 9 mmHg, and mean diastolic gradient as 4 mmHg. Complete closure of the ASD was achieved. Transcatheter treatment may be an effective alternative to surgery in selected patients with Lutembacher syndrome. PMID: 20215845 [PubMed - in process] (Sou...

[Bentall procedure in ascending aortic aneurysm: hospital mortality.]

Cirugia y Cirujanos — Fri, 01 Jan 2010 00:00:00 +0100

Conclusions: Surgical mortality with the Bentall procedure is similar to published results by other specialized centers. Events related to the basic aortic pathology, surgical technique, aortic valve prosthesis and left ventricular dysfunction encourage longterm studies with follow-up. PMID: 20226127 [PubMed - in process] (Source: Cirugia y Cirujanos)

Congenital Complete Absence of the Left Pericardium: A Rare Cause of Chest Pain or Pseudo-right Heart Overload

Clinical Cardiology — Wed, 30 Dec 2009 00:00:00 +0100

We report the cases of 3 patients who have been seen in our institution with a diagnosis of total congenital absence of the pericardium. All of them complained of precordial pain; one of them experienced disabling symptoms that justified surgical intervention. All of them had previously been suspected to have an atrial septal defect because of the echocardiographic appearance of right ventricular volume overload. Electrocardiogram, chest x-ray, echocardiography, and magnetic resonance imaging of the heart consistently showed remarkably similar features including leftward displacement, increased mobility, and interposition of lung tissue between the heart and other intrathoracic structures.Congenital absence of the left pericardium should be known by clinicians as a possible differential di...

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Clinical value of stereoscopic three-dimensional echocardiography in assessment of atrial septal defects: Feasibility and efficiency

Journal of Huazhong University of Science and Technology -- Medical Sciences -- — Mon, 28 Dec 2009 06:42:29 +0100

Summary Stereoscopic three-dimensional echocardiography(S-3DE) is a novel displaying technology based on real-time 3-dimensional echocardiography (RT-3DE). Our study was to evaluate the feasibility and efficiency of S-3DE in the diagnosis of atrial septal defect (ASD) and its use in the guidance for transcatheter ASD occlusion. Twelve patients with secundum ASD underwent RT-3DE examination and 9 of the 12 were subjected to transcatheter closure of ASD. Stereoscopic vision was generated with a high-performance volume renderer with red-green stereoscopic glasses. S-3DE was compared with standard RT-3D display for the assessment of the shape, size, and the surrounding tissues of ASD and for the guidance of ASD occlusion. The appearance rate of coronary sinus and the mean form...

Cardiopulmonary bypass flow rate: A risk factor for hyperlactatemia after surgical repair of secundum atrial septal defect in children

The Journal of Thoracic and Cardiovascular Surgery — Wed, 23 Dec 2009 16:15:28 +0100

Conclusion: Lower weight-indexed cardiopulmonary bypass flow rate is an independent risk factor for early postoperative hyperlactatemia in children after atrial septal defect repair. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Surgical Revision After Percutaneous Mitral Repair With the MitraClip Device [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Fri, 18 Dec 2009 23:25:12 +0100

Conclusions Standard surgical options were preserved in patients who had surgery after percutaneous repair with the MitraClip device. Successful repair was feasible in the majority of patients after the MitraClip procedure, with repair performed as late as 18 months after clip implantation. (Source: The Annals of Thoracic Surgery)

Atrial septal defect (ASD): Readily treatable heart defect

MayoClinic.com Full Feed — Thu, 17 Dec 2009 06:00:00 +0100

Atrial septal defect (ASD) — Comprehensive overview covers symptoms, causes, treatment of this common heart defect. Sponsored by:Chemotherapy.com - http://www.chemotherapy.com (Source: MayoClinic.com Full Feed)

Echocardiographic Detection of Atrial Septal Defects: The Forgotten View

Echocardiography — Thu, 17 Dec 2009 00:00:00 +0100

We describe two cases in which the right parasternal view was helpful in assessment of the interatrial septum and the detection of atrial septal defects (ASD), including one case in which this view confirmed the presence of a defect not seen in any other echocardiographic view. Use of the right parasternal view should be considered for assessment of the interatrial septum, particularly when there is a high index of suspicion for an atrial septal defect but no defect is seen on conventional views. It should also be used to exclude the possibility of multiple defects even when an ASD is visualized using conventional imaging planes. (ECHOCARDIOGRAPHY, Volume **, ************) (Source: Echocardiography)

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Endoscopic treatment of tracheobronchial tree fistulas using atrial septal defect occluders: preliminary results

Jornal Brasileiro de Pneumologia — Sat, 12 Dec 2009 15:06:49 +0100

We report the cases of three patients submitted to endoscopic closure of fistulas, two of which were larger than 10 mm in diameter, by means of the insertion of atrial septal defect occluders. The procedure was minimally invasive, and the initial results were positive. The results indicate that this is a promising technique for the resolution of tracheobronchial tree fistulas. (Source: Jornal Brasileiro de Pneumologia)

Distal femoral duplication and fibular agenesis associated with congenital cardiac defect

Indian Journal of Pediatrics — Sat, 12 Dec 2009 14:30:38 +0100

We report a newborn, who had the congenital anomalies including protuberance on the right lower leg, bilateral equinovarus deformity of the feet, genu valgum with knee flexion deformity, syndactyly between the first and the second digit on the right, in addition with the absence of the fifth digit. Echocardiography revealed a secundum type atrial septal defect. The combination of these congenital defects associated with developmental anomalies of lower extremities. We discuss the clinical, radiological findings and pathogenesis of this lower extremity malformation. Content Type Journal ArticleCategory Clinical BriefDOI 10.1007/s12098-009-0228-5Authors Murat Cakir, Karadeniz Technical University Faculty of Medicine, Department of Pediatrics Trabzon TurkeyLies H. Hoefsloot, Radboud ...

Radiofrequency ablation in an infant with recurrent supraventricular tachycardia and cyanosis

Annals of Pediatric Cardiology — Sat, 12 Dec 2009 13:50:44 +0100

We report an unusual presentation of supraventricular tachycardia, in an infant, with cyanosis. The child had atrial septal defect with hypoplastic right ventricle. Radiofrequency ablation was performed in view of drug resistant SVT (Source: Annals of Pediatric Cardiology)

Molecular genetics of congenital atrial septal defects

Clinical Research in Cardiology — Fri, 11 Dec 2009 06:52:17 +0100

Abstract Congenital heart defects (CHD) are the most common developmental errors in humans, affecting 8 out of 1,000 newborns. Clinical diagnosis and treatment of CHD has dramatically improved in the last decades. Hence, the majority of CHD patients are now reaching reproductive age. While the risk of familial recurrence has been evaluated in various population studies, little is known about the genetic pathogenesis of CHD. In recent years significant progress has been made in uncovering genetic processes during cardiac development. Data from human genetic studies in CHD patients indicate that the genetic aetiology was presumably underestimated in the past. Inherited mutations in genes encoding cardiac transcription factors and sarcomeric proteins were found as an underlyi...

Usefulness of Early Diastolic Mitral Annular Velocity to Predict Plasma Levels of Brain Natriuretic Peptide and Transient Heart Failure Development After Device Closure of Atrial Septal Defect

The American Journal of Cardiology — Sun, 06 Dec 2009 13:50:16 +0100

This study tested the hypothesis that the underlying diastolic dysfunction, assessed on tissue Doppler images (TDI) before device closure, can predict BNP level after ASD closure. The study subjects were 39 consecutive patients (age 27.5 ± 16.3 years, range 5 to 63) who underwent device closure for ASD. Echocardiographic evaluation using TDI and 2-dimensional and pulse wave Doppler were performed, together with plasma BNP measurement 1 day before and 2 days after ASD closure. Before ASD closure, an age-dependent decrease was noted in left ventricular relaxation, assessed by early diastolic mitral annular velocity. ASD closure resulted in a decrease in early diastolic mitral annular velocity (from 14.7 to 12.3 cm/s, p (Source: The American Journal of Cardiology)

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Left atrial myxoma with an atrial septal defect.

Cardiology Journal — Thu, 03 Dec 2009 17:14:03 +0100

Authors: Jegier B, Jaszewski R, Lelonek M In a 62-year old woman with arterial hypertension, a left atrial myxoma and a concomitant atrial septal defect, diagnosed intraoperatively, were recognized. The atrial septal defect was not observed pre-operatively by transthoracic and transoesophageal echocardiography with color Doppler. The myxoma was pedunculated and situated on the inferior part of the interatrial septum and moved to the left ventricle in the diastolic phase. The histopathologic finding was consistent with the diagnosis of myxoma. PMID: 19950097 [PubMed - in process] (Source: Cardiology Journal)

The utility of modified Butler-Leggett criteria for right ventricular hypertrophy in detection of clinically significant shunt ratio in ostium secundum–type atrial septal defect in adults

Journal of Electrocardiology — Thu, 03 Dec 2009 00:00:00 +0100

This study was performed to test the hypothesis that there exists a correlation between the Butler-Leggett (BL) criterion for right ventricular hypertrophy on the electrocardiogram and the Qp/Qs shunt ratio in adults with ostium secundum atrial septal defects (ASDs).Methods: Demographic, cardiac catheterization, ASD closure, and electrocardiographic data were acquired on 70 patients with secundum ASDs closed percutaneously. Simple linear regression and logistic regression models were created to test the hypothesis.Results: The mean Qp/Qs ratio and BL criterion value were 1.61 ± 0.46 and 0.11 ± 0.41, respectively. The BL criterion values correlated with shunt ratios (r2 = 0.11 and P = .004). A BL criterion value greater than 0 mV predicted a significant shunt ratio (Qp/Qs ≥1.5) (odds ra...

The oxidative state of children with cyanotic and acyanotic congenital heart disease.

Anadolu Kardiyol Der... — Tue, 01 Dec 2009 00:00:00 +0100

CONCLUSION: The level of oxidative stress in patients with cyanotic congenital heart disease was significantly higher than in the acyanotic and control groups, which were similar. PMID: 19965321 [PubMed - in process] (Source: Anadolu Kardiyol Der...)

Med Sci Monit 2009; 15(12):CR612-617 "Transcatheter closure as an alternative and equivalent method to the surgical treatment of atrial septal defect in adults: Comparison of early and late results"

Medical Science Monitor — Mon, 30 Nov 2009 15:38:22 +0100

Conclusions: As surgical and device closure appear similarly effective in adults with ASD, avoidance of thoracotomy and cardiopulmonary bypass, in conjunction with a shorter hospital stay, argues in favour of device closure in selected patients. (Source: Medical Science Monitor)

Images of persistent left superior vena cava draining directly into left atrium and secundum-type atrial septal defect

Journal of Cardiovascular Computed Tomography — Mon, 30 Nov 2009 00:00:00 +0100

Abstract: The images of persistent left superior vena cava with the absence of the right superior vena cava are presented in a patient with the diagnosis of secundum-type atrial septal defect. (Source: Journal of Cardiovascular Computed Tomography)

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Metal allergy to amplatzer occluder device presented as severe bronchospasm.

The Annals of Thoracic Surgery — Sat, 28 Nov 2009 00:07:16 +0100

We report a case of severe bronchospasm secondary to a metal allergy after an atrial septal defect device closure requiring device removal. PMID: 19932286 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

High serum levels of procollagen type III N-terminal amino peptide in patients with congenital heart disease

Heart — Fri, 27 Nov 2009 18:01:44 +0100

Conclusion: The increased serum PIIIP levels in proportion to the severity of ventricular load or cyanosis suggest enhanced myocardial synthesis of collagen type III in patients with CHD. Suppression of the PIIIP level by ACEI suggests the involvement of the renin–angiotensin–aldosterone system in myocardial fibrosis. These data provide the basis for the development of new diagnostic and therapeutic strategies in patients with CHD. (Source: Heart)

Giant right ventricular fibroma co-existing atrial septal defect in a 15 year old girl

Cardiology in the Young — Fri, 27 Nov 2009 13:52:36 +0100

In this report, we describe a giant ventricular fibroma co-existing with an atrial septal defect in a girl aged 15 years. (Source: Cardiology in the Young)

Atrial Standstill Causing Congestive Heart Failure in a Child with Ostium Secundum Atrial Septal Defect

Pediatric Cardiology — Wed, 25 Nov 2009 16:49:03 +0100

Abstract Atrial septal defects of the ostium secundum variety are typically asymptomatic in infancy and early childhood. Congestive heart failure (CHF) may occur in the presence of significant mitral valve disease, pulmonary artery hypertension, or other diseases that lead to elevated filling pressures of the ventricles. Atrial standstill, a rare disease, was the probable cause of CHF in the 3-year-old child discussed in this report. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00246-009-9578-zAuthors Ishwar Chandra Malav, All India Institute of Medical Sciences Department of Cardiology, Cardiothoracic Centre Ansari Nagar New Delhi 110029 IndiaRajnish Juneja, All India Institute of Medical Sciences Department of Cardiology, Cardiothoracic Centre Ansari Na...

Retrieval of an embolized amplatzer septal occluder

Catheterization and Cardiovascular Interventions — Tue, 24 Nov 2009 00:00:00 +0100

Percutaneous closure of secundum atrial septal defect (ASD) by various devices has been proven to be an effective and safe treatment modality for patients with congenital heart diseases. However, we have to be aware of the potential early and late complications like device embolization and formulate plan for rescue procedures. We have reported a case of successful closure of a large secundum ASD in a 23-year-old woman by a 40 mm Amplatzer septal occluder (ASO), which embolized into the right ventricle 4 hr after the procedure. This had caused palpitation and nonsustained ventricular tachycardia. Patient safety was our most important concern and after discussion with the cardiac surgeons and the patient, we would like to make a percutaneous stepwise attempt for retrieval. We first applied a...

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Metal Allergy to Amplatzer Occluder Device Presented as Severe Bronchospasm [CASE REPORTS]

The Annals of Thoracic Surgery — Mon, 23 Nov 2009 19:29:54 +0100

We report a case of severe bronchospasm secondary to a metal allergy after an atrial septal defect device closure requiring device removal. (Source: The Annals of Thoracic Surgery)

Atypical atrial flutter in a patient with atrial septal defect without previous surgery: the role of septal defect as a part of the arrhythmia substrate

Europace — Mon, 23 Nov 2009 15:11:54 +0100

This case report describes an atypical right atrial septal flutter in a patient with a non-corrected atrial septal defect. The unique feature of this case report is that reentrant tachycardia with a cycle around the atrial septal defect was non-scar related. The slow conduction around this atrial septal defect was probably formed by right atrial dilatation and intra-cardiac haemodynamic alterations. (Source: Europace)

Amplatzer Septal Occluder Closure of Atrial Septal Defect: Evaluation of Transthoracic Echocardiography, Cardiac CT, and Transesophageal Echocardiography

American Journal of Roentgenology — Fri, 20 Nov 2009 19:03:24 +0100

CONCLUSION. The long axis of a large ASD can be underestimated at TTE. Cardiac CT seems comparable with TEE in the assessment of ASD and is helpful in noninvasive evaluation for Amplatzer septal occluder implantation, especially for large ASD. (Source: American Journal of Roentgenology)

[Perfusion strategies of extracorporeal circulation for robotically assisted cardiac surgery.]

Journal of Southern Medical University — Fri, 20 Nov 2009 00:00:00 +0100

CONCLUSION: The establishment of ECC system through peripheral vessels, certain learning curve of perfusion technique and close communication between the surgical team are the key points of ECC for totally robotically assisted cardiac surgery, and VAVD and continuous blood gas monitoring are essential during ECC. PMID: 19923091 [PubMed - as supplied by publisher] (Source: Journal of Southern Medical University)

Higher Risk of Adverse Pregnancy Outcomes When Septal Defects Are Unrepaired

Medscape Today Headlines — Wed, 18 Nov 2009 16:54:00 +0100

The risk of adverse neonatal events is higher when mothers have unrepaired atrial septal defects, while pregnant women with repaired septal defects have neonatal event rates that are generally similar to controls, researchers say based on a new study. Reuters Health Information (Source: Medscape Today Headlines)

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GATA4 Mutations in Chinese Patients with Congenital Cardiac Septal Defects

Pediatric Cardiology — Sat, 14 Nov 2009 06:58:57 +0100

Abstract The object of the study was to elucidate the mutations of the GATA4 gene in Han ancestry patients with congenital cardiac septal defects. Fifty Han ancestry patients with sporadic and familial cardiac septal defects and 200 normal subjects of the same ethnical background were studied. A total of six exons and the intron–exon boundaries of GATA4 were amplified by polymerase chain reaction (PCR). The PCR products were purified and directly sequenced with an ABI PRISM 3730 Automatic DNA sequencer. Two novel heterozygous mutations were discovered in the GATA4 gene in five children with cardiac septal defects (10%, 5/50), His28Tyr in exon 2 and His436Tyr in exon 7, respectively, which were neither found in the control population nor reported in the SNP database at the ...

Population-based Assessment of Familial Inheritance and Neurologic Comorbidities among Patients with an Isolated Atrial Septal Defect

Congenital Heart Disease — Fri, 13 Nov 2009 00:00:00 +0100

Conclusions. There is a strong familial inheritance pattern for isolated interatrial shunt, with significantly higher risk of interatrial shunt among affected patients' siblings, first-, and second-degree relatives. Relatives of affected individuals also had a higher risk of TIA, a trend toward an increased risk for stroke, but no increased risk of migraine headache. (Source: Congenital Heart Disease)

Large destructive facial hemangioma in PHACE syndrome

Journal of Indian Association of Pediatric Surgeons — Tue, 10 Nov 2009 15:59:27 +0100

We report an infant who presented with large facial hemangioma associated with Dandy-Walker cyst and atrial septal defect. This case is peculiar in that the large facial hemangioma in posterior fossa malformations, hemangiomas, arterial anomalies, coarctation of aorta and other cardiac defects (PHACE) syndrome resulted in massive tissue destruction. (Source: Journal of Indian Association of Pediatric Surgeons)

Atrioventricular block after transcatheter ASD closure using the Amplatzer septal occluder: Risk factors and recommendations

Catheterization and Cardiovascular Interventions — Tue, 10 Nov 2009 00:00:00 +0100

We report two patients who developed atrioventricular (AV) block within 48 hr after uncomplicated device closure of ASD using the Amplatzer septal occluder (ASO) device. Despite trials of high dose steroids and non-steroidal anti-inflammatory agents in both patients, the response was inadequate and by the end of the first week, both patients were ultimately sent for surgical removal of their devices with complete resolution of their atrioventricular conduction abnormalities. We discuss the possible etiology and risk factors of AV block and propose recommendations for management of such a complication. © 2009 Wiley-Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

ARTICLE: Antibacterial Medication Use During Pregnancy and Risk of Birth Defects: National Birth Defects Prevention Study

Archives of Pediatrics — Mon, 02 Nov 2009 21:01:14 +0100

Conclusions Reassuringly, penicillins, erythromycins, and cephalosporins, although used commonly by pregnant women, were not associated with many birth defects. Sulfonamides and nitrofurantoins were associated with several birth defects, indicating a need for additional scrutiny. (Source: Archives of Pediatrics)

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Antibacterial Medication Use During Pregnancy and Risk of Birth Defects: National Birth Defects Prevention Study [Article]

Archives of Pediatrics — Mon, 02 Nov 2009 21:01:14 +0100

CT appearance of persistent left superior vena cava, anomalous right superior pulmonary venous return into the right-sided superior vena cava and a sinus venosus-type atrial septal defect.

The British Journal of Radiology — Sun, 01 Nov 2009 00:00:00 +0100

We present findings of persistent left superior vena cava, anomalous right superior pulmonary venous return into the right-sided superior vena cava and a sinus venosus-type atrial septal defect detected incidentally by CT pulmonary angiography. To our knowledge, there has been no previous case report with all of the above findings detected by CT. In addition to the radiological findings and their clinical significance, the anatomy and embryological explanation of each anomaly is discussed. PMID: 19890118 [PubMed - in process] (Source: The British Journal of Radiology)

Should we close hypoxaemic patent foramen ovale and interatrial shunts on a systematic basis?

Archives of Cardiovascular Diseases — Sun, 01 Nov 2009 00:00:00 +0100

CONCLUSION: Hypoxaemic shunts are treated effectively by transcatheter closure, resulting in functional improvement in patients without respiratory insufficiency. When associated with chronic respiratory insufficiency, hypoxaemia often persists after shunt closure. In such cases, the right-to-left atrial shunt does not seem to be the main cause of hypoxaemia and the indication for closure is questionable. PMID: 19944391 [PubMed - in process] (Source: Archives of Cardiovascular Diseases)

Percutaneous closure of a secundum atrial septal defect after surgical pericardectomy.

Cardiovascular Journal of Africa — Sun, 01 Nov 2009 00:00:00 +0100

Authors: Yalonetsky S, Lorber A A case of successful closure of a percutaneous atrial septal defect following surgical pericardectomy is described. Clinical and haemodynamic aspects of atrial septal defects associated with constrictive pericarditis are also discussed. PMID: 20024476 [PubMed - in process] (Source: Cardiovascular Journal of Africa)

Repair of atrial septal defects on the perfused beating heart.

Texas Heart Institute Journal — Sat, 31 Oct 2009 12:32:03 +0100

We present our experience in repairing all varieties of atrial septal defects with the aid of continuous antegrade perfusion of an empty beating heart with normothermic blood.From September 1999 through December 2008, 266 patients (140 females and 126 males; ages 3-53 yr) underwent atrial septal defect closure by this method. Of these patients, 236 had ostium secundum, 21 had sinus venosus, and 9 had ostium primum defects. Three patients also had rheumatic mitral incompetence requiring mitral valve implantation, and 2 also had mitral stenosis requiring valvuloplasty. Preoperative diagnoses were established by 2-dimensional echocardiography and color-flow Doppler study. The size of atrial septal defects ranged from 2 cm through 4.5 cm. Direct repair was performed in 52 patients, and the res...

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An empirically based tool for analyzing mortality associated with congenital heart surgery

The Journal of Thoracic and Cardiovascular Surgery — Mon, 19 Oct 2009 15:20:42 +0100

Conclusion: The proposed risk scores and categories have a high degree of discrimination for predicting mortality and represent an improvement over existing consensus-based methods. Risk models incorporating these measures may be used to compare mortality outcomes across institutions with differing case mixes. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Ministernotomy for repair of congenital cardiac disease [Institutional report - Congenital]

Interactive CardioVascular and Thoracic Surgery — Wed, 14 Oct 2009 16:58:28 +0100

We report our experience with repair of a variety of congenital heart defects utilizing a ministernotomy incision. A ministernotomy was used in 79 patients with a variety of congenital heart diseases from November 2004 to August 2007. Patients included 36 males and 43 females with ages ranging from 1 month to 122 months (median age, 22 months). The weight ranged from 3.5 kg to 40 kg (median weight, 10.9 kg). There were no deaths, and one conversion to full median sternotomy (1/79, 1.3%). The median cardiopulmonary bypass time was 59 min, and median aortic cross-clamp time was 38 min. One patient underwent atrial septal defect (ASD) repair with fibrillatory arrest time of 35 min. The operating time ranged from 103 min to 312 min (median operating time...

Genetic screening of 104 patients with congenitally malformed hearts revealed a fresh mutation of GATA4 in those with atrial septal defects

Cardiology in the Young — Wed, 14 Oct 2009 12:51:09 +0100

Research ArticlesHaruka Hamanoue, Sri Endah Rahayuningsih, Yuya Hirahara, Junko Itoh, Utako Yokoyama, Takeshi Mizuguchi, Hirotomo Saitsu, Noriko Miyake, Fumiki Hirahara, Naomichi Matsumoto, Cardiology in the Young, Volume 19 Issue 05 , pp 482-485AbstractWe analysed the GATA binding protein 4 gene, or GATA4, along with the NK2 transcription factor related, locus 5 gene, or NKX2.5, to determine their genetic contribution to 104 sporadic patients in Indonesia with congenitally malformed hearts, 76 cases having atrial septal defect and 28 tetralogy of Fallot. We found only 1 novel mutation of GATA4 in those with atrial septal defecst. Analysis of the genetic background of the parents of the patient showed for the first time that a new mutation of GATA4 can cause sporadic atrial septal defects....

Complete congenital obstruction of a scimitar vein in an infant with severe respiratory failure

Cardiology in the Young — Wed, 14 Oct 2009 12:51:09 +0100

We report an infant of 3 1/2 months with complete obstruction of the venous component of the scimitar syndrome, a large atrial septal defect within the oval fossa, a common left pulmonary vein, and pulmonary hypertension. To the best of our knowledge, ours is the first description of complete congenital obstruction of a scimitar vein. (Source: Cardiology in the Young)

Catheter closure of an atrial septal defect in anatomically corrected malposition with left juxtaposition of atrial appendages

Cardiology in the Young — Wed, 14 Oct 2009 12:51:09 +0100

In this report, I describe the insertion of a device to close an atrial septal defect, as guided by transoesophageal echocardiography. (Source: Cardiology in the Young)

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Transesophageal Echocardiography for Device Closure of Atrial Septal Defects: Case Selection, Planning, and Procedural Guidance

Journal of the American College of Cardiology: Cardiovascular Imaging — Mon, 12 Oct 2009 21:01:48 +0100

(Source: Journal of the American College of Cardiology: Cardiovascular Imaging)

Impact of Occluder Device Type on Success of Percutaneous Closure of Atrial Septal Defects–A Medium-Term Follow-up Study

Journal of Interventional Cardiology — Sun, 11 Oct 2009 23:00:00 +0100

Conclusions: Percutaneous closure of patent foramen ovale or atrial septal defect is a safe procedure with little incidence of peri- and postprocedural complications. There is a significant difference between the Amplatzer[trade], Cardiastar[trade], and Starflex[trade] occluders in regard to complete closure of the defects and annual recurrence of thromboembolic events. (J Interven Cardiol 2009;**:1[ndash]8) (Source: Journal of Interventional Cardiology)

Anatomical Factors Triggering Platypnea-Orthodeoxia in Adults

Clinical Cardiology — Wed, 07 Oct 2009 23:00:00 +0100

We report a case series of patients presenting with dyspnea and orthodeoxia who developed right to left shunting as a result of associated anatomical changes that occur with aging such as tortuosity and elongation of the aorta. We propose that these acquired anatomical changes can favor right to left shunting in the setting of congenital abnormalities, therefore explaining the late onset of symptoms. Copyright © 2009 Wiley Periodicals, Inc. (Source: Clinical Cardiology)

[The epidemiology of congenital heart disease in Asturias (Spain) during the period 1990-2004.]

Anales de Pediatria — Wed, 07 Oct 2009 23:00:00 +0100

CONCLUSIONS: The prevalence of CHDs in Asturias over this period falls within the range reported for other European registries. The apparent increase in prevalence of CHD results mainly from improved diagnosis of minor defects, but there has been no change over time in birth prevalence of more serious defects. PMID: 19819200 [PubMed - as supplied by publisher] (Source: Anales de Pediatria)

Scimitar Sign in a Patient With an Atrial Septal Defect: A Comprehensive Noninvasive Assessment With Transthoracic Echocardiography and Computed Tomography

Journal of the American College of Cardiology — Wed, 07 Oct 2009 14:07:16 +0100

A 30-year-old woman was referred for a percutaneous atrial septal defect (ASD) closure. She was acyanotic. She had a systolic ejection murmur and a wide-fixed split S2. The chest radiograph showed cardiomegaly; pulmonary arterial hypertension; and the “scimitar sign” (A, arrows), a curvilinear opacity created by the anomalous right pulmonary vein (PV) draining into the inferior vena cava (IVC). An echocardiogram demonstrated a secondum ASD (B, arrows, Online Video 1) with left-to-right shunt and anomalous right PVs (scimitar vein) (C, black arrows, Online Video 2), confirmed by spectral Doppler (D), emptying into IVC-right atrial junction. Contrast-enhanced computed tomography showed a large scimitar vein (E, arrows) created by a splice of right superior (F, arrow) and inferior (F, arr...

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Association between prepregnancy body mass index and congenital heart defects

American Journal of Obstetrics and Gynecology — Mon, 05 Oct 2009 00:00:00 +0100

Conclusion: These results corroborated those of previous studies and suggested new associations between obesity and conotruncal defects and RVOT defects. (Source: American Journal of Obstetrics and Gynecology)

Haemodynamic effects of patent foramen ovale and atrial septal defect closure: a comparison during percutaneous shunt closure

Clinical Physiology and Functional Imaging — Sun, 04 Oct 2009 23:00:00 +0100

Conclusions: Using non-invasive finger pressure measurements, we found that SV, mean and systolic blood pressure increased immediately after percutaneous closure of an ASD in adults, whereas the percutaneous PFO closure had no effect on haemodynamic characteristics. (Source: Clinical Physiology and Functional Imaging)

Moebius syndrome with atrial septal defect.

Singapore Medical Journal — Thu, 01 Oct 2009 00:00:00 +0100

Authors: Thapa R, Bhattacharya A PMID: 19907896 [PubMed - in process] (Source: Singapore Medical Journal)

Real-time 3-dimensional transesophageal echocardiogram guidance of percutaneous atrial septal defect closure reduces radiation exposure

Cardiovascular Revascularization Medicine — Wed, 30 Sep 2009 23:00:00 +0100

Image guidance for percutaneous atrial septal defect (ASD) closure uses fluoroscopy combined with either transesophageal echocardiogram (TEE) or intracardiac echocardiography (ICE). Real-time three-dimensional TEE (RT3D-TEE) improves depth resolution, defect characterization, and device visualization. Using a database, we compared the safety, efficacy, and efficiency of using RT3D-TEE to guide percutaneous ASD closure to ICE. (Source: Cardiovascular Revascularization Medicine)

Absence of pericardium in combination with bronchogenic cyst, atrial septal defect, mitral valve prolapsus and hypospadias.

Anadolu Kardiyol Der... — Wed, 30 Sep 2009 23:00:00 +0100

Authors: Ozpolat B, Doğan OV PMID: 19819782 [PubMed - in process] (Source: Anadolu Kardiyol Der...)

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Transcatheter closure of multiple atrial septal defects in an adolescent

Pediatrics International — Sun, 27 Sep 2009 23:00:00 +0100

(Source: Pediatrics International)

Living-Donor Lobar Lung Transplantation and Closure of Atrial Septal Defect for Adult Eisenmenger's Syndrome

The Journal of Heart and Lung Transplantation — Fri, 25 Sep 2009 17:57:42 +0100

A 38-year-old woman with Eisenmenger's syndrome underwent bilateral living-donor lobar lung transplantation and simultaneous closure of atrial septal defect. The grafts were a right lower lobe from her husband and a left lower lobe from her brother. Although only 2 lobes were implanted, the dramatic improvement in pulmonary hemodynamics has been well maintained for more than 5 years. Living-donor lobar lung transplantation and simultaneous cardiac repair may be one of the therapeutic options for patients with adult Eisenmenger's syndrome with simple congenital heart disease. (Source: The Journal of Heart and Lung Transplantation)

Percutaneous patent foramen ovale/atrial septal defect closure: just because we can?

The Annals of Thoracic Surgery — Thu, 24 Sep 2009 02:16:14 +0100

Authors: Opotowsky AR, Webb GD PMID: 19766861 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Minimally invasive operation for congenital heart disease: A sex-differentiated approach

The Journal of Thoracic and Cardiovascular Surgery — Tue, 22 Sep 2009 18:13:37 +0100

Objectives: Since 1996, we have routinely used a minimally invasive sex-differentiated surgical approach for surgical repair of various simple congenital heart diseases, mostly including a right anterior minithoracotomy in female subjects and a midline ministernotomy in male subjects.Methods: Between August 1996 and December 2004, all patients who underwent a sex-differentiated surgical approach were included. Hospital results were compared with those of a group undergoing full sternotomy (control subjects). Patients' clinical conditions and satisfaction at follow-up were evaluated.Results: Three hundred eight patients underwent the sex-differentiated surgical approach: (1) minithoracotomy in 147 (47.7%) and (2) ministernotomy in 161 (52.3%). Thirty patients had a full sternotomy for atria...

Percutaneous Patent Foramen Ovale/Atrial Septal Defect Closure: Just Because We Can? [CORRESPONDENCE]

The Annals of Thoracic Surgery — Mon, 21 Sep 2009 23:00:00 +0100

(Source: The Annals of Thoracic Surgery)

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Association of congenital cardiovascular malformations with 33 single nucleotide polymorphisms of selected cardiovascular disease-related genes

Birth Defects Research Part A: Clinical and Molecular Teratology — Thu, 17 Sep 2009 23:00:00 +0100

CONCLUSIONS: Genes affecting vascular function and coagulation appear to be promising candidates for the etiology of cardiac malformations and warrant further study. Birth Defects Research (Part A), 2009. © 2009 Wiley-Liss, Inc. (Source: Birth Defects Research Part A: Clinical and Molecular Teratology)

Pulmonary function changes in children after transcatheter closure of atrial septal defect

Pediatric Pulmonology — Thu, 17 Sep 2009 23:00:00 +0100

This study was performed to assess changes in pulmonary function test (PFT) and pulmonary outcome after transcatheter closure of atrial septal defect (ASD) in pediatric patients. A total 55 pediatric patients undergoing transcatheter ASD closure received PFT at baseline (day before ASD closure), and at 3 days and 6 months after procedure. Forced vital capacity (FVC), forced expired volume in 1 sec (FEV1), FEV1 to FVC ratio (FEV1/FVC), peak expiratory flow (PEF), and mean forced expiratory flow during the middle half of FVC (FEF25-75) were measured. Individually, subjects were classified by spirometry as normal, obstructive or restrictive, to evaluate the effect of transcatheter closure on pulmonary outcome. These 55 children had significantly reduced mean PEF and FEF25-75 (84 ± 24%, P = 0...

Eustachian Valve as a Cardiovascular Patch

Heart, Lung & Circulation — Thu, 17 Sep 2009 16:16:09 +0100

This report describes the uses of a large Eustachian valve as a cardiovascular patch. In one patient, the large Eustachian valve was used to close an atrial septal defect and in another patient it was used to create a tunnel during the lateral tunnel Fontan operation. (Source: Heart, Lung & Circulation)

Congenital Partial Absence of the Left Pericardium Suspected on the Classical Chest X-ray

Heart, Lung & Circulation — Thu, 17 Sep 2009 16:16:09 +0100

Congenital absence of the left pericardium is a rare phenomenon occurring as a result of abnormal embryologic development of the left cardinal vein which normally develops into the left pleuropericardial membrane. Congenital pericardial defects can occur alone or in association with other congenital anomalies. Although diagnosis with conventional imaging techniques is difficult to make, this condition can be identified through chest X-ray by: (1) levo-rotation of the heart with displacement of the apex to the left, (2) linear shape of the left cardiac silhouette with erasure of the aortic knob, and (3) a flattened right cardiac silhouette in the absence of longstanding tricuspid valve regurgitation. displays the above mentioned signs in an 18-year-old lady who underwent surgical closure of...

Spectrum of congenital heart defects in Croatia

European Journal of Pediatrics — Wed, 16 Sep 2009 19:02:58 +0100

Abstract The aim of our study was to investigate the incidence of congenital defects in children born in Croatia during a period of 5 years, its association with extracardiac malformations, its treatment, and outcome. Medical information about the patients was obtained from 14 paediatric cardiology centres that cover the whole country. Diagnosis was made by clinical findings, electrocardiography, chest X-ray, echocardiography, catheterisation, or autopsy. Between October 1, 2002 and October 1, 2007, there were 205,051 live births in Croatia, 1,480 of which were patients diagnosed with congenital heart disease, accounting for 0.72% of the live-born children. The distribution was made up of 34.6% children with ventricular septal defect, 15.9% with atrial septal defect, ...

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Inherited 14q duplication and 21q deletion: A rare adjacent-2 segregation in multiple family members

American Journal of Medical Genetics Part A — Tue, 15 Sep 2009 23:00:00 +0100

We present a family with multiple carriers of a subtle balanced translocation t(14;21)(q21.2;q21.2) and three patients with a resultant adjacent-2 malsegregation containing a +der(14)t(14;21)(q21.2;q21.2),-21 in their chromosome complement. The initial study was performed when a 2-month-old female was referred to genetics clinic for evaluation of developmental delay, growth retardation, and failure to thrive. Physical findings included prominent eyes, micrognathia, prominent and simple external ears, camptodactyly, contractures of the wrists, ankles, and hips, hypoplasia of the corpus callosum, prominent atria and occipital horns, cerebellopontine hypoplasia; and small atrial septal defect. High resolution chromosomes showed an extra band on the proximal 21q and fluorescence in situ hybrid...

Severe subaortic stenosis that progressed over a 12-year period after cardiac surgery

Journal of Medical Ultrasonics — Tue, 15 Sep 2009 21:43:32 +0100

Abstract A 12-year-old girl who had undergone cardiac surgery for ventricular septal defect (VSD), atrial septal defect (ASD), and patent ductus arteriosus (PDA) in infancy was referred to our institution for fatigue and excessive sweating. Transthoracic and transesophageal echocardiographic studies revealed tunnel-type subaortic stenosis with aortic valvular stenosis, for which she underwent aortic valve replacement and myomectomy of left ventricular outflow tract. Progression of subaortic stenosis should be considered in patients with only mild aortic valve stenosis after previous cardiovascular surgery. Echocardiography contributed significantly to making the diagnosis and therapeutic decision in our patient. Content Type Journal ArticleCategory Case ReportDOI 10.1007...

Is a predominant left-to-right shunt associated with migraine?: A prospective atrial septal defect closure study

Catheterization and Cardiovascular Interventions — Tue, 08 Sep 2009 23:00:00 +0100

Conclusion: We found a high prevalence of migraine in patients with an ASD, and observed prospectively a reduction in the occurrence of migraine, especially migraine with aura, 1 year after percutaneous closure. © 2009 Wiley-Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Persistent Tricuspid Regurgitation and Its Predictor in Adults After Percutaneous and Isolated Surgical Closure of Secundum Atrial Septal Defect

The American Journal of Cardiology — Mon, 07 Sep 2009 16:15:53 +0100

In conclusion, functional TR was ameliorated after percutaneous and isolated surgical ASD closure, although persistent TR was common. The presence of pulmonary hypertension before ASD closure predicted persistent TR; therefore, corrective TV surgery should be considered at ASD closure in adult patients with moderate or severe TR and concomitant pulmonary hypertension. (Source: The American Journal of Cardiology)

Molecular analysis of KAL-1 in a series of Kallmann syndrome and normosmic idiopathic hypogonadotropic hypogonadism patients from Northwestern China.

Asian Journal of Andrology — Sun, 06 Sep 2009 23:00:00 +0100

This report describes two intragenic deletions of KAL-1 in two KS patients and suggests that KAL-1 deletion might be more prevalent in KS patients with other congenital organ abnormalities than those described previously in other series from Northwestern China. PMID: 19734936 [PubMed - as supplied by publisher] (Source: Asian Journal of Andrology)

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Figulla ASD Occluder versus Amplatzer Septal Occluder: A Comparative Study on Validation of a Novel Device for Percutaneous Closure of Atrial Septal Defects

Journal of Interventional Cardiology — Thu, 03 Sep 2009 23:00:00 +0100

Conclusions: Both devices are clinically safe and effective in ASD closure. FSO device has similar outcomes when compared to ASO device. Difficulties in selecting the correct device size in larger defects and larger venous sheath requirement need to be evaluated in further studies. (J Interven Cardiol 2009;**:1[ndash]7) (Source: Journal of Interventional Cardiology)

Pulse Densitometer Indocyanine Green Dilution Curves: A Simple Applicable and Accurate Method for Determination of Cardiac Shunts

Congenital Heart Disease — Wed, 02 Sep 2009 23:00:00 +0100

Conclusion. Transcutaneous recording of dye dilution curves with a pulse dye densitometer allows easy and accurate quantification of intracardiac left-to-right shunt flows over a wide range in both children and adults with congenital heart diseases. (Source: Congenital Heart Disease)

A Blue Baby Grows Up

Congenital Heart Disease — Wed, 02 Sep 2009 23:00:00 +0100

This report describes the history of a 41-year-old female patient born with atresia of the right atrioventricular valve, hypoplasia of the right ventricle, an atrial septal defect, and malposed great arteries. The patient underwent surgical pulmonary artery banding in infancy but did not undergo corrective surgery due to the development of pulmonary arterial hypertension. This report touches on several important clinical issues that may arise when caring for the adult with complex palliated cyanotic congenital heart disease, including the development and treatment of pulmonary arterial hypertension. (Source: Congenital Heart Disease)

Utilization of the Edge-to-Edge Valve Plasty Technique to Correct Severe Tricuspid Regurgitation in Patients with Congenital Heart Disease

Journal of Cardiac Surgery — Tue, 01 Sep 2009 23:00:00 +0100

Conclusions: Edge-to-edge valve plasty is an easy, effective, and acceptable additional procedure to correct severe tricuspid regurgitation in patients with congenital heart disease. (J Card Surg ****;**:**-**) (Source: Journal of Cardiac Surgery)

An Alternative Method for Cardioplegia Delivery during Totally Endoscopic Robotic Surgery

Journal of Cardiac Surgery — Tue, 01 Sep 2009 23:00:00 +0100

The optimal technique for myocardial protection and cardioplegia delivery during totally endoscopic robotic surgery is still under evolution. Cardioplegia delivery with endovascular clamping of the aorta is a common method used for this purpose but has several disadvantages and may lead to serious complications. Here we describe an alternative cardioplegia delivery method during totally endoscopic atrial septal defect closure and mitral valve repair. The method using a transthoracic aortic clamp and an antegrade cardioplegia cannula without any thoracotomy seems to be a safe and reproducible technique, which may enhance myocardial protection and prevent some of the complications of the endoclamp technique during robotically assisted cardiac surgery. (J Card Surg ****;**:**-**) (Source: Jou...

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Atrial Septal Defect Devices Used in the Cardiac Catheterization Laboratory

Progress in Cardiovascular Nursing — Tue, 01 Sep 2009 23:00:00 +0100

An atrial septal defect (ASD) is a hole in the atrium of the heart. There are 3 types of ASDs; sinus venosus (high in the atrial septum), secundum ASD (middle of septum), and ostium primum (low in the septum). The most common ASD is a secundum ASD. Secundum ASDs are caused by a failure of the atrial septum to close completely during the development of the heart. The most common reported symptoms are fatigue and shortness of breath. Most patients are found to have an ASD after evaluation for a murmur. All ASDs used to be repaired by open heart surgery. However, with advances in the cardiac catheterization lab and development of new devices, some secundum ASDs are able to be closed in the catheterization lab by an interventional cardiologist. There are various types of devices that may be us...

Complex cardiac congenital defects in an adult dog: An ultrasonographic and magnetic resonance imaging study.

The Canadian Veterinary Journal — Tue, 01 Sep 2009 00:00:00 +0100

This article describes a complex and not previously reported combination of congenital cardiac defects. Echocardiography showed dilation of right and left chambers, accompanied with patent ductus arteriosus, persistence of the left cranial vena cava, atrial septal defect (ASD), subaortic stenosis, and tricuspid dysplasia. The interatrial wall was examined and the diameter of the ASD was measured by magnetic resonance imaging (MRI). PMID: 19949552 [PubMed - in process] (Source: The Canadian Veterinary Journal)

[Fulfillment of the prevention of endocarditis guidelines after percutaneous closure of atrial septal defects.]

Anales de Pediatria — Mon, 31 Aug 2009 23:00:00 +0100

CONCLUSIONES: The latest guidelines on antibiotic prophylaxis of endocarditis are increasingly restrictive in their indications in order to promote a more rational use of antibiotics. More studies are needed on the indications of antibiotic prophylaxis in endocarditis in patients with an intracardiac device, in order to establish concrete or evidence-based guidelines. Meanwhile, it is our responsibility to avoid the indiscriminate application of antibiotics, and involve the families and other health professionals. PMID: 19729355 [PubMed - as supplied by publisher] (Source: Anales de Pediatria)

Endobronchial Closure of Total Bronchopleural Fistula With Occlutech Figulla ASD N Device [CASE REPORTS]

The Annals of Thoracic Surgery — Sun, 30 Aug 2009 23:00:00 +0100

We describe the endoscopic closure of a bronchial total fistula with the Occlutech Figulla ASD N device (International Occlutech AB, Helsingborg, Sweden), originally designed for closure of an atrial septal defect. The procedure was conducted without general anesthesia or rigid bronchoscopy, bronchography, or radioscopy. An immediate reduction in the air leak was observed and also later on bronchoscopy, as the device was almost covered by granulation tissue. The endobronchial technique described seems to be safe and effective to manage large bronchopleural fistulas. (Source: The Annals of Thoracic Surgery)

Right Ventricular Remodeling after Transcatheter Closure of Atrial Septal Defect

Echocardiography — Thu, 27 Aug 2009 23:00:00 +0100

Conclusions: Transcatheter closure of ASD results in rapid normalization of RV volume overload and improvement of RV function. (ECHOCARDIOGRAPHY, Volume **, ************) (Source: Echocardiography)

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Comparison of outcomes of minimally invasive mitral valve surgery for posterior, anterior and bileaflet prolapse [Original articles]

European Journal of Cardio-Thoracic Surgery — Thu, 27 Aug 2009 23:00:00 +0100

Conclusions: Minimally invasive MV repair can be achieved with excellent results. Long-term outcomes and reoperation rates for AML prolapse are not significantly different from PML or BL prolapse. (Source: European Journal of Cardio-Thoracic Surgery)

A new method for endoscopic closure of gastrocolonic fistula: novel application of a cardiac septal defect closure device (with video)

Gastrointestinal Endoscopy — Wed, 26 Aug 2009 12:07:53 +0100

Conclusions: Successful endoscopic closure of gastrocolonic fistula can be achieved, even with long-standing, fibrotic fistulous tracts by using a novel endoscopic approach. (Source: Gastrointestinal Endoscopy)

Port-access minimally invasive surgery for atrial septal defects: A 10-year single-center experience in 166 patients

The Journal of Thoracic and Cardiovascular Surgery — Wed, 26 Aug 2009 00:00:00 +0100

Conclusions: Port-access minimally invasive surgery for atrial septal defects is a safe, less-invasive, reproducible, and cosmetic operation, providing an excellent outcome and an effective correction, and could be now considered the standard approach for this type of patient. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Endobronchial closure of total bronchopleural fistula with Occlutech Figulla ASD N device.

The Annals of Thoracic Surgery — Tue, 25 Aug 2009 16:25:34 +0100

Paradoxical amniotic fluid embolism presenting before caesarean section in a woman with an atrial septal defect

International Journal of Obstetric Anesthesia — Tue, 25 Aug 2009 00:00:00 +0100

We present a case of presumed amniotic fluid embolism in a 33-year-old parturient at 30 weeks of gestation, which occurred just before she was due to receive spinal anaesthesia for urgent caesarean section. While sitting, the woman suddenly lost consciousness, started having convulsions and finally suffered cardiorespiratory collapse. She was resuscitated and a live baby was delivered by emergency caesarean section. An echocardiogram performed postoperatively showed a large atrial septal defect and severe right ventricular dysfunction with moderate pulmonary hypertension. Paradoxical amniotic fluid embolism was diagnosed. After extubation she was aphasic and had a right hemiparesis. She made a good recovery and was discharged from hospital 24 days later, at which time she had a slight weak...

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Partial atrioventricular septal defect in the fetus: diagnostic features and associations in a multicenter series of 30 cases.

The Ultrasound Review of Obstetrics and Gynecology — Sun, 23 Aug 2009 23:00:00 +0100

CONCLUSIONS: We describe the key echocardiographic features of pAVSD in the fetus. In addition, we have confirmed that the association with trisomy 21 holds also for pAVSD, though to a lesser extent, with a 12.5% association rate in this series. In the fetus, pAVSD seems to be associated with a high rate of chromosomal/non-chromosomal syndromic conditions, including skeletal dysplasias. Inutero, aortic coarctation represents the most frequently associated cardiac lesion (13.3%). Copyright (c) 2009 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 19705406 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Pulmonary arterial hypertension and congenital heart disease: Targeted therapies and operability

The Journal of Thoracic and Cardiovascular Surgery — Sun, 23 Aug 2009 13:31:51 +0100

To the Editor: We read with great interest the case report of Hoetzenecker and colleagues of a patient with severe pulmonary arterial hypertension associated with an atrial septal defect and the beneficial effect of bosentan, which allowed for closure of the defect. This is a very interesting topic that raises a lot of controversies in the field of pulmonary arterial hypertension associated with congenital heart disease. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Reply to the Editor

The Journal of Thoracic and Cardiovascular Surgery — Sun, 23 Aug 2009 13:31:51 +0100

We thank Dr Beghetti and colleagues for their thoughtful comments regarding the hemodynamic evaluation and further management of our recent case of atrial septal defect (ASD). The management of patients with a degree of pulmonary vascular disease prior to shunt closure has been a matter of debate. In addition, recent studies demonstrating the efficacy of oral vasodilators in pulmonary vascular disease associated with congenital systemic-to-pulmonary shunts have fueled an uncertainty of vasodilator pretreatments prior to shunt closure. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Comparison of pregnancy outcomes in women with repaired versus unrepaired atrial septal defect

BJOG: An International Journal of Obstetrics and Gynaecology — Thu, 13 Aug 2009 23:00:00 +0100

Conclusions Women with an unrepaired ASD are at increased risk of neonatal events in comparison with women with a repaired ASD. Compared with the general population, women with an unrepaired ASD are at increased risk of pre-eclampsia, small-for-gestational-age births and fetal mortality. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)

Comparison of pregnancy outcomes in women with repaired versus unrepaired atrial septal defect.

BJOG : An International Journal of Obstetrics and Gynaecology — Wed, 12 Aug 2009 23:00:00 +0100

Conclusions Women with an unrepaired ASD are at increased risk of neonatal events in comparison with women with a repaired ASD. Compared with the general population, women with an unrepaired ASD are at increased risk of pre-eclampsia, small-for-gestational-age births and fetal mortality. PMID: 19681849 [PubMed - as supplied by publisher] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)

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Acute right to left shunt through patent foramen ovale presenting as hypoxemia after myocardial infarction: a case report

Cases Journal — Tue, 11 Aug 2009 23:00:00 +0100

Conclusion: A right to left atrial shunt is a rare complication of inferior myocardial infarction with right ventricular infarction. The diagnosis should be considered in the presence of inferior myocardial infarction when hypoxemia persists despite administration of 100% oxygen. Early diagnosis and treatment are critical in order to reduce the risk of embolization and to prevent end-organ damage due to hypoxemia. (Source: Cases Journal)

Transcatheter Atrial Septal Defect Closure with the AMPLATZER® Atrial Septal Occluder in 13 Dogs: Short- and Mid-Term Outcome

Journal of Veterinary Internal Medicine — Mon, 10 Aug 2009 23:00:00 +0100

Transcatheter atrial septal defect (ASD) closure in the dog was first reported in 2005. Describe the technique and both short- and mid-term outcome of transcatheter ASD closure with the Amplatzer® atrial septal occluder (ASO). Thirteen client-owned dogs with ASD. Records of the initial 13 dogs in which transcatheter ASD closure was attempted at Texas A&M University were reviewed. All dogs had hemodynamically relevant septum secundum ASD. Two dogs had concurrent congenital abnormalities. ASOs were deployed in 13 dogs and released in 12. Eleven were released by a right jugular approach and 1 by a transatrial approach through a right lateral thoracotomy. Transthoracic echocardiographic estimates of ASD size were 14.0 ± 5.4 mm (mean ± 1 standard deviation) with a range of 7[ndash]22 mm. Acc...

Early and Late Cardiac Perforation by Amplatzer Atrial Septal Defect and Patent Foramen Ovale Devices

Journal of the American Society of Echocardiography — Sun, 02 Aug 2009 23:00:00 +0100

Cardiac perforation and device erosion are infrequent but potentially lethal complications of percutaneous occluder device insertion. Transthoracic and transesophageal echocardiography (TEE) and gated cardiac computed tomography are useful in detecting this complication. In particular, TEE can detect characteristic features to confirm the diagnosis before rapid surgical correction. Deficient superior-anterior rim and encroachment of the occluder device on the posterior atrial wall are risk factors for device erosion. TEE performed before device insertion with awareness of manufacturer's guidelines for atrial geometry and device sizing may reduce the occurrence of this serious complication. (Source: Journal of the American Society of Echocardiography)

Application of Real-Time Three-Dimensional Transesophageal Echocardiography Using a Matrix Array Probe for Transcatheter Closure of Atrial Septal Defect

Journal of the American Society of Echocardiography — Sun, 02 Aug 2009 23:00:00 +0100

Conclusion: RT3D-TEE is a clinically useful, complementary option to 2D-TEE for evaluation of ASD morphology and for interventional guidance. (Source: Journal of the American Society of Echocardiography)

Use of Real Time Three-Dimensional Transesophageal Echocardiography in Intracardiac Catheter Based Interventions

Journal of the American Society of Echocardiography — Fri, 31 Jul 2009 23:00:00 +0100

Conclusion: RT3D TEE is a powerful new imaging tool that may become the technique of choice and the standard of care for guidance of selected percutaneous catheter-based procedures. (Source: Journal of the American Society of Echocardiography)

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Scimitar vein anomaly with total right-side pulmonary vein return to inferior vena cava concomitant with atresia of upper right-side pulmonary vein and secundum atrial septal defect.

The Heart Surgery Forum — Fri, 31 Jul 2009 23:00:00 +0100

We describe its diagnostic and surgical approach. PMID: 19683996 [PubMed - in process] (Source: The Heart Surgery Forum)

AGA Medical Patent Declared Valid in U.K. Patent Infringement Lawsuit against Occlutech

HSMN NewsFeed — Fri, 31 Jul 2009 13:04:55 +0100

MINNEAPOLIS, July 31--(HSMN NewsFeed)--AGA Medical Holdings, Inc. (AGA) today announced that a U.K. court has determined that an AGA-held patent for its Atrial Septal Defects (ASD) and Patent Foramen Ovale (PFO) devices is valid. However, the U.K. court de... Devices, Cardiology, LitigationAGA Medical, Occlutech, Atrial Septal Defect, Patent Foramen Ovale (Source: HSMN NewsFeed)

Med Sci Monit 2009; 15(8):CR409-412 "Down’s syndrome and the pattern of congenital heart disease in a community with high parental consanguinity"

Medical Science Monitor — Fri, 31 Jul 2009 11:40:24 +0100

Conclusions: A slightly higher frequency of CHD was documented in DS children from this population with a high consanguineous marriage rate. The frequencies of specific lesions were similar to those reported locally and internationally; VSD was the most frequently detected in this study. Interesting was the predominance of left-right shunt lesions and the relative rarity of cyanotic and complex CHD in this DS population. (Source: Medical Science Monitor)

L’angiocardiografia isotopica nei difetti del setto atriale con cortocircuito sinistro-destro

International Journal of Clinical & Laboratory Research — Fri, 31 Jul 2009 06:55:16 +0100

Summary Radioisotopic angiocardiography using99mTc pertechnetate and a scintillation camera were performed on a group of 12 patients presenting atrial septal defect with one-way left to right shunt. The findings of major diagnostic value in this heart disease were: contemporaneous presence of radioactivity which was visualized with varying intensity in the four heart chambers during the late phases; persistence of radioactivity in the lungs; non-visualization of the aorta. In some cases presenting considerable left to right shunt, the right atrium was visualized with much more intensity than the right ventricle and the pulmonary artery. This pattern does not depend on an anatomic obstacle at the level of the tricuspidal valve, but most probably on hemodynamic factors relate...

Constrictive pericarditis in a patient with sinus venosus atrial septal defect and anomalous right upper pulmonary venous return

Annals of Pediatric Cardiology — Thu, 30 Jul 2009 10:45:48 +0100

Santosh C Uppu, Sruti Chandrasekaran, Kiran K MallulaAnnals of Pediatric Cardiology 2009 2(1):87-88This is a report of a 49-year-old male, who presented with typical signs and symptoms of constrictive pericarditis. He was diagnosed with sinus venosus atrial septal defect (ASD) and anomalous right upper pulmonary venous return during his adolescence, which was elected not to be repaired. During the attempted repair of the ASD it was noted there was a thick fibrous material covering the heart, which had progressed over time leading to frank constrictive pericarditis. His ASD spontaneously closed over time. There have been less than 10 cases reported with constrictive pericarditis of nonsurgical etiology in a patient with ASD, and none with sinus venosus ASD. (Source: Annals of Pediatric Card...

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The Effect of Short-Term Prophylactic Acetylsalicylic Acid on the Incidence of Postpericardiotomy Syndrome After Surgical Closure of Atrial Septal Defects

Pediatric Cardiology — Tue, 28 Jul 2009 06:14:32 +0100

This study evaluated the effectiveness of acetylsalicylic acid (ASA) prophylaxis in preventing PPS after surgical closure of atrial septal defects (ASDs) in pediatric patients. A retrospective review was performed for 177 patients who underwent uncomplicated ASD closure from 1986 to 2006. The study group received prophylactic ASA 20 to 50 mg/kg/day for 1 to 6 weeks after surgery, whereas the control group did not. The primary outcome was a diagnosis of PPS based on the presence of two or more of the following symptoms or signs occurring at least 72 h postoperatively: fever (temperature >38°C), pericardial or pleural rub, and worsening or recurring anterior pleuritic chest pain. Consequently, PPS developed in 5 (2.8%) of the 177 children: 2.8% (3/106) in the control...

First experience With the biostar-device for various applications in pediatric patients With congenital heart disease

Catheterization and Cardiovascular Interventions — Mon, 27 Jul 2009 23:00:00 +0100

Conclusion: The BioSTAR closure device is a safe and effective device for the closure of a variety of interatrial shunts in children including multifenestrated interatrial defects and fontan fenestrations, however, possible long term consequences (e.g., fractures, recurrent shunts after scaffold degradation) remain to be studied. © 2009 Wiley-Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Transcatheter Diagnosis and Intervention for Iatrogenic Right-to-Left Shunts Decades After Surgical Repair of Partial Anomalous Pulmonary Veins and an Atrial Septal Defect

Pediatric Cardiology — Sat, 18 Jul 2009 19:38:24 +0100

Abstract A 57-year-old man presented with symptomatic right-to-left shunts decades after surgical closure of an atrial septal defect and partial anomalous pulmonary veins. Two sources of shunting were identified: a baffle leak from the right superior vena cava (RSVC) to the left atrium secondary to complete occlusion of the RSVC-to-right atrium connection and an acquired previously unpublished coronary sinus to the left atrial shunt secondary to inadvertent closure of the coronary sinus. The diagnosis and transcatheter management of these unusual right-to-left shunts are reported. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00246-009-9487-1Authors Abhay Divekar, University of Iowa Children’s Hospital Division of Pediatric Cardiology, Department of Ped...

Outcomes of Pregnancy in Patients with Preexisting Postural Tachycardia Syndrome

Pacing and Clinical Electrophysiology : PACE — Thu, 16 Jul 2009 23:00:00 +0100

Conclusion: Based on our observation, patients with POTS can safely complete pregnancy if they desire to do so. POTS should not be considered a contraindication to pregnancy per se. (PACE 2009; 32:1000[ndash]1003) (Source: Pacing and Clinical Electrophysiology : PACE)

Interrupted inferior vena cava and partial anomalous pulmonary venous return with atrial septal defect in a 38 year-old adult: a case report

Cases Journal — Wed, 15 Jul 2009 23:00:00 +0100

We present a woman having congenital anomalies of the inferior vena cava and partial anomalous pulmonary venous return from the right lung with atrial septal defect in a 38 year-old. Congenital anomalies of inferior vena cava are rare. They are seen more often in young males. If there are not other anomalies, they are latent for a long time. Peripheral venous thrombosis, chronic venous insufficiency, dyspnea and fatigue are often the first symptoms of these anomalies. Surgical repair of atrial septal defect with partial anomalous pulmonary venous return include provision of durably unobstructed systemic and pulmonary venous pathways, closure of the atrial septal defect, and avoidance of arrhythmias. The diagnosis has been determined by compression ultrasonography with color doppler assessm...

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Mosaic trisomy 1q: The longest surviving case

American Journal of Medical Genetics Part A — Wed, 15 Jul 2009 23:00:00 +0100

We present the longest known surviving case of a male infant with a mosaic complete trisomy 1q. Born at 39 weeks of gestation with respiratory distress, his weight was 3,330 g (25th centile); he had micrognathia, a posterior cleft of palate, abnormal ears and left thumb, syndactyly, and an absent corpus callosum. Initial blood karyotype was normal (46,XY). He died at age 5 months. Autopsy suggested aspiration as the primary cause of death and confirmed the antemortem findings of an absent corpus callosum and atrial septal defect. It also identified some central nervous system, cardiac, gastrointestinal, and lung anomalies not previously recognized. Cytogenetic analysis of skin fibroblasts obtained at autopsy showed a de novo unbalanced translocation between chromosomes 1 and 22: 46,XY,+1,d...

Journal Scan: Prevalence and Repair of Intraoperatively Diagnosed Patent Foramen Ovale and Association With Perioperative Outcomes and Long-Term Survival (JAMA 2009;302:290-297.)

Cardiosource — Tue, 14 Jul 2009 16:00:00 +0100

Intraoperative transesophageal echocardiograms from 13,092 patients undergoing surgery at the Cleveland Clinic from 1995 through 2006 were reviewed for evidence of PFO. No patients had a prior diagnosis of PFO or atrial septal defect prior to surgery. Postoperative outcomes were prospectively collec. . . (Source: Cardiosource)

Atrial septal defects: Magnetic resonance and computed tomography appearances

Australasian Radiology — Mon, 13 Jul 2009 23:00:00 +0100

Atrial septal defects are associated with significant morbidity and mortality. Echocardiography is the first-line imaging modality, but MR and CT imaging can provide complimentary information, especially for the detection of associated anomalies and for assessing changes in the pulmonary vasculature. The aim of this pictorial essay is to review the spectrum of atrial septal defects, with particular reference to their cross-sectional imaging appearances and issues pertaining to management. (Source: Australasian Radiology)

ORIGINAL CONTRIBUTION: Prevalence and Repair of Intraoperatively Diagnosed Patent Foramen Ovale and Association With Perioperative Outcomes and Long-term Survival

JAMA — Mon, 13 Jul 2009 23:00:00 +0100

Conclusions Incidental PFO is common in patients undergoing cardiothoracic surgery but is not associated with increased perioperative morbidity or mortality. Surgical closure appears unrelated to long-term survival and may increase postoperative stroke risk. (Source: JAMA)